> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.

# Sleep diary

> Consensus Sleep Diary single-day entry for CBT-I — bedtime, onset, awakenings, wake time, quality, daytime impact.

The sleep diary is the foundational data collection tool of CBT for
Insomnia. The client logs one day at a time — when they got into bed, how
long it took to fall asleep, how many times they woke, when they got out of
bed, how rested they felt — and the practitioner reads the patterns at the
weekly review.

Rivet uses the Consensus Sleep Diary structure (Carney et al. 2012), which
the sleep medicine field developed specifically to standardize sleep
self-monitoring across research and clinical settings.

## What it captures

Fifteen fields, single-day entry.

* **Date** — defaults to today
* **Time you got into bed** — string ("23:30")
* **Time you fell asleep (estimate)** — string
* **How long it took to fall asleep (minutes)** — integer (sleep onset
  latency)
* **Number of times you woke during the night** — integer
* **Total time awake during those awakenings (minutes)** — integer
* **Time you woke up for the day** — string
* **Time you got out of bed** — string
* **Estimated total hours of sleep** — decimal
* **Sleep quality** — 0-10 slider, very poor → very good
* **How rested you felt today** — 0-10 slider, exhausted → well rested
* **Total daytime naps (minutes)** — integer
* **Caffeine after noon** — boolean
* **Alcohol in the evening** — boolean
* **Anything else worth noting** — textarea, optional

No total score — the clinical signal is the pattern across many entries.

## What the practitioner reads

The fields are arranged to produce the variables CBT-I works with:

* **Sleep onset latency** (time-to-fall-asleep) — > 30 minutes is the
  insomnia threshold. The target of stimulus control and sleep
  restriction.
* **Wake after sleep onset (WASO)** — the awakening-minutes field. The
  target of sleep consolidation.
* **Total sleep time** vs **time in bed** — the ratio is sleep efficiency.
  ≥ 85% is adequate; \< 80% is the insomnia threshold. Sleep restriction
  targets this ratio directly.
* **Daytime impact** — the rested rating captures whether the night
  translated into daytime function.
* **Lifestyle factors** — caffeine and alcohol entries surface obvious
  targets for sleep hygiene work without making the worksheet a generic
  habits checklist.

## When to use it

* **CBT-I treatment.** Daily for 1-2 weeks as baseline before any
  intervention, then ongoing during the active treatment phase.
* **Insomnia screening.** Two weeks of sleep diary alongside an
  [ISI](/clinical-templates/screening/isi) gives a much more reliable
  picture than ISI alone, because the diary captures the actual
  behavioral pattern rather than the client's retrospective summary.
* **Sleep symptoms in depression or anxiety treatment** — the diary
  surfaces whether sleep is the maintenance mechanism worth targeting
  directly, or whether mood/anxiety improvement is dragging sleep along.
* **PTSD with sleep symptoms** — nightmares, frequent awakenings, and
  short total sleep are common in PTSD; the diary tracks whether
  trauma-focused treatment is reducing the sleep load.

## In-session mechanics

Open **Sleep diary** from the top-right corner (**Clinical templates ▾**). You typically review prior
responses (the client's homework entries) from the client's record, rather
than filling new entries in-session — the daily fill is between-session
homework.

When reviewing, the most useful display is the per-day comparison. Open
several recent responses in turn and scan onset latency, WASO, and
sleep-efficiency-relevant numbers (bedtime vs out-of-bed-time, total sleep
hours) to read the pattern.

## Citation

Carney, C. E., Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Krystal,
A. D., Lichstein, K. L., & Morin, C. M. (2012). "The Consensus Sleep
Diary: Standardizing prospective sleep self-monitoring." *Sleep,* 35(2):
287-302.

Buysse, D. J. (2008). "Insomnia." *JAMA,* 309(7): 706-716. (Source for the
sleep efficiency severity bands.)

The Consensus Sleep Diary was published specifically to standardize the
field; the structure is published clinical method and uncopyrightable.
All field labels are original to Rivet.

## When not to use it

* **Acute insomnia from a clearly identifiable transient cause.** A bad
  week after a death, a job loss, or a medical event isn't always
  chronic insomnia and doesn't necessarily need the structured diary.
  Re-assess after 2-4 weeks.
* **Severe sleep-disordered breathing suspected.** Loud snoring,
  witnessed apneas, daytime sleepiness disproportionate to time in bed
  point at sleep apnea, which needs polysomnography and medical
  workup rather than CBT-I.
* **Clients for whom self-monitoring drives anxiety about sleep.**
  Performance anxiety about sleep is a sub-target of CBT-I; for some
  clients the daily diary itself makes the performance anxiety worse.
  Shorter-window monitoring (one week at a time, with breaks) can
  scaffold this.

## Related articles

<CardGroup cols={2}>
  <Card title="ISI" icon="moon" href="/clinical-templates/screening/isi">
    The 7-item Insomnia Severity Index — pre/post outcome instrument that pairs with the diary.
  </Card>

  <Card title="PSQI" icon="bed" href="/clinical-templates/screening/psqi">
    Pittsburgh Sleep Quality Index — broader sleep-quality screen for
    research-grade pre/post measurement.
  </Card>

  <Card title="Mood diary" icon="chart-line" href="/clinical-templates/cbt/mood-diary">
    For days when mood is the variable to track alongside sleep.
  </Card>
</CardGroup>
